A BLINDED, RANDOMIZED, PAIRED, PLACEBO-CONTROLLED TRIAL OF 20-MINUTE EMLA CREAM TO REDUCE THE PAIN OF PERIPHERAL IV CANNULATION IN THE ED

A eutectic mixture of local anesthetics (EMLA) in cream form has been used as a topical anesthetic to reduce the pain of procedures penetrat ing the skin. It is generally applied for 45 to 60 minutes before the painful procedure. The purpose of this study was to determine whether a 20-minute application of EMLA is useful in reducing the pain of rout ine peripheral intravenous cannulation in the emergency department (ED ), A blinded, randomized, placebo controlled, paired trial compared th e pain of intravenous cannulation in both hands of study subjects: one hand was treated with 20-minute EMLA cream and the other hand was tre ated with 20-minute placebo cream, Forty subjects identified the more painful hand and scored pain measurements of each hand using a 10-cm v isual analog scale. These data failed to demonstrate any significant b enefit of EMLA compared with placebo. EMLA is not useful for intraveno us cannulation when used for 20-minute application times, There may be more effective and less costly ways of reducing the pain of intraveno us cannulation that patients would prefer. Copyright (C) 1998 by W.B. Saunders Company.